Sample Record for 2026-07-25-1
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 994675 DEA: 07390204 EFIS: 0722000334
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-47-0.4 / 2.1
Work Description: Bridge deck replacement with lightweight precast deck panels ultra high performance concrete. Also includes: replacement of seismic sensors, upgrades to median barrier, railings, fences and guard rails. New finger joints.
Location Description: RTE 47 between Terminal Island and San Pedro PM 0.4/2.1
Contractor Name: Skanska
Contractor Address: 1995 Agua Mansa Rd, Riverside, CA 92509
Resident Engineer: Sam Gallardo Structure Rep.: Sami Deeb
Sample Information
DIME Sample ID: 2026-07-25-1
TL Number from the TL Form:
Sample Submitted By Organization: Coreslab
Sample Organization Contact: 951-943-9119
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 07/25/2026
Date that the sample was received by the laboratory/organization performing the testing: 07/24/2026
The quantity of what the sample constitutes: Three 4x8 cylinders
A brief description of the sample: 4x8 concrete cylinders/Concrete Sample
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Coreslab Structures
Material Information
The concrete mix design number: 2556 hydrolite
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 106401
Concrete batch plant: In house
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: laboratory
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
Test Results
